Taking out half a kid's brain can be best option to stop seizures, research confirms

When doctors told Pete and Michelle Gallagher that they wanted to
remove half of their 3-year-old son's brain, the Attica, Ohio, parents
were horrified. But a new study shows the extreme procedure may offer
some kids their best shot at a normal life.

The
couple also knew that the dramatic surgery known as a hemispherectomy
might be the only workable option to stop the severe seizures, more than
a dozen a day, that were robbing Aiden of his ability to function – and
to learn.

"He had forgotten his alphabet. He had forgotten how to count. It was all slipping," the father said.

Today,
Aiden is a healthy, red-haired fifth-grader who goes to regular school
and loves to play baseball and basketball. He hasn't had a seizure since
the rare operation, making the boy a poster child for new research that
finds the procedure offers real-world success for children suffering
from devastating epilepsy.

"The brain has an amazing capacity to work around the function that
it has lost," said Dr. Ajay Gupta, head of pediatric epilepsy at the
Cleveland Clinic.

In the first large-scale study to look at the
everyday capabilities of kids who undergo hemispherectomy, Gupta and his
colleagues reviewed 186 operations performed at their center between
1997 and 2009 and took a close look at 115 patients.

They
confirmed what doctors knew, but had little practical data to support:
That removing the diseased hemisphere of a seizure-prone brain allows
sufferers to learn and grow and, in some cases, lead normal lives.

"It
answers the questions that parents have: Would he be able to talk,
would he be able to see, would he be able to read?" Gupta told NBC News.

Only
a tiny fraction of the 3 million Americans who have epilepsy are
eligible for hemispherectomy, which involves either total removal of
half of the brain, or removing part and disconnecting the links between
the two halves. Though no one keeps track of how many times this surgery
is performed, Gupta figures his high-volume center does 15 or 16
procedures a year. They're typically used when anti-seizure medications
no longer quiet the electrical storms that ravage the brain.

Aiden
suffered his first seizure at 10 months. Doctors controlled them with
drugs until he was 3, when the medications stopped working and he was
seizing virtually around the clock. Surgery quickly became the only
option.

"They removed almost all of the right side of his brain," Pete Gallagher said.

The
new study, published Friday in the journal Epilepsia, reviewed records
of Aiden and other Cleveland Clinic patients ages 2 to 28, mostly
children who developed epilepsy before the age of 3. Three-quarters of
the patients had daily seizures and another 18 percent had seizures
every week, the study found.

After the surgery, more than half of
patients – 56 percent – were seizure-free. Another 36 percent still had
seizures, but about 15 percent of them saw a more than 90 percent
reduction in their frequency.

Researchers found that 83 percent
of patients were able to walk independently, and 70 percent had
satisfactory speaking skills. Nearly 60 percent of kids were able to
participate in mainstream schools with assistance, and 42 percent of
children older than 6 had satisfactory reading skills. Five of the 24
adults who had surgery were holding down jobs.

Those might sound
like mixed results to some, but not to Dr. Gary Mathern, a professor of
neurosurgery at the David Geffen School of Medicine at the University of
California, Los Angeles.

"Given that if you had not done the
intervention most of these kids would be so severely disabled, the
results are actually pretty positive," said Mathern, a surgeon whose
nationally renowned hemispherectomy program competes with the Cleveland
Clinic's. He was a reviewer on the paper and is now a co-editor of the
journal.

Without surgery, a child with severe epileptic seizures
might have an IQ of 50. With surgery, that might jump to 70, Mathern
said.

The findings in the new study are not surprising, but they
do serve a valuable purpose, especially for parents weighing the risks
and benefits of the surgery.

"It gives them a range of expectations," Mathern said.

Still,
few parents reject the surgery that can stop seizures – and the
dependence on anti-seizure drugs, which have their own debilitating
effects.

In Aiden's case, his improvement began the minute he
woke from the operation and reached for his dad with his formerly
useless left hand, his dad said. A week later, he was running at a local
playground.

"I didn't think the recovery would be anywhere near the point that it is," Pete Gallagher said.

The
success of Aiden's surgery and the return of calm to family life led
the parents to have another child, Evann, now 5. They say they're
grateful that both boys can work and play together.

"Aiden's kind
of our hero because of all the crap he's been through," Gallagher said.
"I think there are absolutely no limitations for him. Just when we
think there might be something he can't do, he does it."

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